Although the only reported deaths have occurred in Michigan, state and federal health officials continue investigating the outbreak and any additional sources of infection. Michigan health officials said both residents who died had significant underlying medical conditions. At least 278 people associated with the multistate lettuce outbreak were hospitalized, according to the FDA. Taylor Farms initiated a voluntary recall July 17 and removed iceberg lettuce sourced from central Mexico from the U.S. market. Instead, they should monitor official recall notices, discard recalled products and follow standard food-handling practices.